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Access to Public Transportation and Health Facilities Offering Long-Acting Reversible Contraceptives among Residents of Formal and Informal Settlements in Two Cities in Kenya

Citation

Escamilla, Veronica; Calhoun, Lisa M.; Odero, Norbert; & Speizer, Ilene S. (2019). Access to Public Transportation and Health Facilities Offering Long-Acting Reversible Contraceptives among Residents of Formal and Informal Settlements in Two Cities in Kenya. Reproductive Health, 16, 161. PMCID: PMC6839122

Abstract

BACKGROUND: Despite improved health facility access relative to rural areas, distance and transportation remain barriers in some urban areas. Using household and facility data linked to residential and transportation geographic information we describe availability of health facilities offering long-acting reversible contraceptive (LARC) methods and measure access via matatus (privately owned mid-size vehicles providing public transport) in urban Kenya.
METHODS: Study data were collected by the Measurement, Learning and Evaluation (MLE) Project. Location information for clusters (2010) representative of city-level population were used to identify formal and informal settlement residents. We measured straight-line distances between clusters and facilities that participated in facility audits (2014) and offered LARCs. In Kisumu, we created a geographic database of matatu routes using Google Earth. In Nairobi, matatu route data were publicly available via the Digital Matatus Project. We measured straight-line distance between clusters and matatu stops on 'direct' routes (matatu routes with stop(s) RESULTS: There were 141 (Informal = 71; Formal = 70) study clusters in Nairoibi and 73 (Informal = 37; Formal = 36) in Kisumu. On average, residential clusters in both cities were located CONCLUSIONS: Overall, formal and informal settlement clusters were within walking distance of a facility offering LARCs, and multiple matatu stops were accessible to get to further away facilities. This level of access will be beneficial as efforts to increase LARC use expand, but the role of wealth and transportation costs on access should be considered, especially among urban poor.

URL

http://dx.doi.org/10.1186/s12978-019-0828-0

Reference Type

Journal Article

Year Published

2019

Journal Title

Reproductive Health

Author(s)

Escamilla, Veronica
Calhoun, Lisa M.
Odero, Norbert
Speizer, Ilene S.

PMCID

PMC6839122